Nebraska Legislature Approves Bill To Protect Doctors Who Recommend Medical Marijuana

*“Today marks a small step forward, but we are up against incredible odds.”*

*By Zach Wendling, Nebraska Examiner*

Health care practitioners who want to recommend medical cannabis to
Nebraska patients are one step closer to having legal protections for
writing the recommendation in the face of some state leaders’ opposition.

The Legislature voted 30-7 on Friday to advance Legislative Bill 933, from
State Sen. John Cavanaugh of Omaha. It would protect medical providers from
criminal, civil or disciplinary penalties “solely” for issuing a written
recommendation or stating that in their professional judgment, the
potential benefits of cannabis outweigh potential harms.

“It would create a step forward and hope and an opportunity for these
families who have worked so hard, who have waited so long and would like to
be able to have that conversation with their doctors and then potentially
get some relief,” Cavanaugh said during debate.

Lawmakers clarified that the practitioner wouldn’t be protected from
malpractice or professional negligence claims, such as for not evaluating a
patient or following the appropriate standard of care. An amendment to that
end from Cavanaugh passed 35-4, as did a similar amendment from the
Legislature’s Health and Human Services Committee, in a separate 38-4 vote.

State Sen. Brian Hardin of Gering, HHS Committee chair, opposed LB 933 in
committee but said the added language was an “important clarification.”

“Practitioners are protected for the recommendation itself but remain fully
responsible for conducting a thorough and appropriate patient evaluation
before making it,” Hardin said.

“Malpractice or professional negligence” is defined in law as failure to
use “ordinary and reasonable care, skill and knowledge ordinarily possessed
and used under like circumstances by members of his profession engaged in a
similar practice in his or in similar localities.”

In the 2024 general election, 71 percent of voters legalized possession of
up to 5 ounces of medical cannabis with a recommendation, and 67 percent of
voters created the regulatory Nebraska Medical Cannabis Commission.
Getting to 33 votes

Similar provider protections were included in a bill offering a larger
regulatory framework proposed in 2025, LB 677 from State Sen. Ben Hansen of
Blair. The bill failed 23-22, short of 33 necessary votes to overcome a
filibuster.

Cavanaugh’s LB 933 also would need 33 votes to change laws passed by
voters, as required under the Nebraska Constitution.

There remains a path to get there, with 12 senators either absent from or
sitting out Friday’s vote. One of them, State Sen. Rick Holdcroft of
Bellevue, who was “present, not voting,” supported LB 677 10 months ago but
did not vote to advance LB 933. He’s the lone LB 677 supporter in that boat.

Holdcroft helped get LB 677 out of the General Affairs Committee as
committee chair. He said his biggest concern last year was funding for the
commission, which is being remedied this year through state budget
adjustments in LB 1071 and a separate General Affairs bill, LB 1235.

Holdcroft noted the Medical Cannabis Commission has just finished licensing
four cultivators, who have indicated it might be eight months to a year
before there is enough crop for manufacturing and later distribution.

“To start giving immunity to doctors who are going to make recommendations
for a product that we’re not even going to have for a year is, I think, a
little bit premature,” Holdcroft said.

Cavanaugh, Hansen and other advocates argue the protections are needed so
an eventual state program can exist. To date, they say no in-state
physician has issued a recommendation, in part over fear of retribution,
such as from law enforcement. And without protections, supporters worry
there will be no patients able to access commission-licensed facilities.

Nebraska Attorney General Mike Hilgers (R) rallied law enforcement against
Hansen’s LB 677 in 2025 and spoke against the health care practitioner
language. His office did not formally oppose LB 933, nor did the Nebraska
Department of Health and Human Services.
‘Preponderance of scientific evidence’

State Sen. Jared Storm of David City, who led opposition to LB 677 last
year, introduced an amendment to Cavanaugh’s bill to require that the
health care practitioner’s recommendation be “based upon a preponderance of
the current scientific evidence.”

Storm argued the “simple and straightforward addition” was rooted in the
Hippocratic Oath to “do no harm.”

“If you’re against this amendment, you’re for recreational marijuana,”
Storm said. “If you are for my amendment, you’re looking at this as
medicine.”

Cavanaugh argued the opposite, that LB 933 would support advocates and not
push them to instead rally for recreational marijuana due to delays of
accessing medical marijuana. Hansen made a similar plea last year.

“If you do not want a recreational program, we must make our medical
program functional,” Cavanaugh said.

Storm, Hansen and Cavanaugh alike said they aren’t aware of any doctors who
have been sued for malpractice or negligence for recommending medical
cannabis nationwide.
‘Moral hazard’ or ‘dangerous road’?

State Sens. Tanya Storer of Whitman and Bob Andersen of Sarpy County argued
as Storm did that the debate was around public safety rather than medical
cannabis.

Said Storer: “Immunity creates a moral hazard. When there are no
consequences, there is less incentive to exercise caution.”

Cavanaugh and Hansen worried about the long-term implications of Storm’s
proposal, arguing that it “muddies the water.” Hansen said it “could come
back and bite us in the butt” around certain medications, such as
Ivermectin used during the COVID-19 pandemic.

Cavanaugh said he had talked with the Nebraska Medical Association and the
malpractice provider for the association, who Cavanaugh said told him that
Storm’s amendment would “create more uncertainty.”

Hansen, a former HHS Committee chair, said he did understand where Storm
was coming from and knows Storm’s opinion around medical cannabis. Hansen
said using a “preponderance of scientific evidence” would exclude upward of
38 percent of medications issued off-label.

“I think we’re gonna go down a very dangerous road in the future about
micromanaging how a medical professional can prescribe medication for the
future,” Hansen said.
‘Bit of a fixer-upper’

State Sen. Carolyn Bosn of Lincoln, a former prosecutor, clarified with
Cavanaugh that nothing in LB 933 would protect a professional’s license if
they went against their professional judgment. She said the legal standard
is based on someone’s education, training and experience. She supported the
protections.

Storm said one issue was the difference between a “recommendation” for
medical cannabis cannabis and a “prescription.” He noted opioids, for
instance, are tracked under the state’s Prescription Drug Monitoring
Program. Hansen proposed using that system in LB 677.

Hardin, who ultimately did not vote on the advancement of LB 933, said he
supported Storm’s amendment. He said marijuana had been studied “since
wagons were crossing within a mile of my house on the Oregon Trail,” and
that with dozens of states legalizing marijuana, the question is how to do
that in the “safest possible way.”

“I think it’s a little bit of a fixer-upper, and I think we’re getting
there,” Hardin said.

Storm’s amendment failed 22-19. It’s possible he may try again in future
debate, as five senators were not at the State Capitol on Friday, including
Storer.
‘Small step forward’

Crista Eggers of Nebraskans for Medical Marijuana said she was encouraged
by the advancement of LB 933 but that some of the debate, particularly
around Storm’s amendment, shows continued opposition to a functioning state
program.

“Today marks a small step forward, but we are up against incredible odds as
this bill looks to move on to select file and final reading,” Eggers said
after the vote.

“Nebraskans have had few wins in this over-decade-long fight,” she
continued. “Today is one of them.”

LB 933 faces up to two more rounds of debate before, with 33 votes, it
could be sent to Nebraska Gov. Jim Pillen for his signature.

*Vote to advance Legislative Bill 933 related to medical cannabis*

*Aye (30):* John Arch, Carolyn Bosn, Eliot Bostar*, Tom Brandt*, John
Cavanaugh*, Machaela Cavanaugh*, Stan Clouse*, Danielle Conrad*, Wendy
DeBoer*, Barry DeKay, Myron Dorn*, George Dungan*, John Fredrickson*,
Dunixi Guereca*, Ben Hansen*, Jana Hughes*, Megan Hunt*, Margo Juarez*,
Terrell McKinney*, Fred Meyer, Glen Meyer*, Jason Prokop*, Dan Quick*, Jane
Raybould*, Merv Riepe, Victor Rountree*, Rita Sanders, Ashlei Spivey, Brad
von Gillern and Dave Wordekemper*.

*Nay (7):* Bob Andersen, Rob Clements, Mike Jacobson, Kathleen Kauth, Loren
Lippincott, Dave Murman and Jared Storm.

*Present, not voting (7):* Christy Armendariz, Beau Ballard, Brian Hardin,
Rick Holdcroft*, Teresa Ibach, Mike Moser and Tony Sorrentino.

*Excused, not voting (5): *Rob Dover, Bob Hallstrom, Dan Lonowski, Tanya
Storer and Paul Strommen.

*Voted for a broader medical cannabis framework proposed in 2025
(Legislative Bill 677).

*This story was first published by Nebraska Examiner.*

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